hiv@hepc is viramune o.k.?

Nov 4, 2004

i use to be on viracept and epiver and zerit for 5 years.for the last 3 years i have been drug free. my viral load was undetectable for many years. just recently my doctor checked for hepc @found out i have it. millions he said the viral load is / he said for hepc it was average. my hiv viral load is and has been arounnd 10,000 for maybe one and a half years. my doctor wants to put me on viramune i am afraid because my liver enzymes have started to jump. is this the best choice? and what should i start first? the hiv therapy or the hepc ?i have been positive for 16 yearswithoutany oppurtunistic diseases but i know i have had hep c longerlike 25 years . i am mad at my doctor for not checking my hepc back when my liver was healthy. my husband and son are both negative for everything. and i work full time. please help me decide , my t/cell count is around 225 and because the majority of my docs patients are homosexual malesi don"t think he always knows whats right for me iam 46 years old without any other health problems.

Response from Dr. Henry

The best way to know if you need treatment for hepatitis C is to get a liver biopsy. I usually get a hep C genotype to help assess whether you stand a good chance to respond to peg interferon/ribavirin therapy for the hep C (type 1 genotype has a lower response rate). We don;t know the answer regarding what is the best sequence for treatment patients with both HIV and hepatitis C. If the liver is already irritated (by biopsy with due to elevated enzymes ) I often would use a drug other than nevirapine (Susiva or a boosted PI). KH

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